围手术期限制性输液对高龄胃肠手术患者肝肾功能及预后的影响  

Influence of restrictive transfusion during perioperative period on hepatorenal function and prognosis in elderly patients with gastrointestinal surgery

作　　者：徐宙[1] 陈勇[1] XU Zhou;CHEN Yong(Department of General Surgery,Baoshan Branch,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201900,China)

机构地区：[1]上海中医药大学附属曙光医院宝山分院普外科,上海201900

出　　处：《安徽医药》2018年第12期2365-2368,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨围手术期限制性输液对高龄胃肠手术患者肝肾功能及预后的影响。方法 130例择期接受胃肠手术的高龄患者按照围手术期输液方式采用随机数字表法分为限制性输液组和常规输液组,各65例。比较两组液体出入量、肝肾功能变化、术后胃肠功能恢复情况及并发症发生率。结果限制性输液组总输液量、尿量较常规输液组明显降低(P <0. 05)。术后两组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)均较术前明显升高,其中限制性输液组ALT明显高于常规输液组(P <0. 05);与常规输液组比较,限制性输液组术后首次排气、排便时间及住院时间均明显缩短(P <0. 05);限制性输液组总并发症发生率4. 6%明显低于常规输液组15. 4%(P <0. 05)。结论在维持循环稳定与保证器官灌注的前提下,围手术限制性输液对高龄胃肠手术患者有助于促进胃肠道功能恢复,降低术后并发症和改善预后,且未对肝肾功能造成明显不利影响。Objective To explore the impact of restrictive transfusion during perioperative period on hepatorenal function and prognosis in elderly patients with gastrointestinal surgery.Methods 130 elderly patients who were scheduled for gastrointestinal surgery were divided randomly into two groups,including restriction group(n=65)and convention group(n=65),according to the mode of fluids infusion during perioperative period.Volume of fluid infusion,change of hepatorenal function before and after operation were observed,and postoperative gastrointestinal function recovery and complications were compared between the two groups.Results The volume of total transfusion and urine in restriction group was significantly decreased than that in convention group(P<0.05).The level of AST,ALT in the two group after operation were all increased,and the level of ALT in restriction group was significantly higher than that in convention group(P<0.05).Compared with convention group,the first time of aerofluxus and defecation,hospital stay in restriction group were significantly reduced(P<0.05).The total incidence of complications in restriction group was significantly decreased than that in convention group(4.6%vs.15.4%,P<0.05).Conclusion On the basis of keeping cycle stability and organ perfusion,restrictive transfusion during perioperative period fluid resuscitation could help elderly patients with gastrointestinal surgery to promote the recovery of gastrointestinal function,reduce postoperative complications and improve prognosis,and without obvious adverse effects on hepatorenal function.

关 键 词：限制性输液 围手术期 胃肠手术 高龄 肝肾功能 预后 

分 类 号：R656[医药卫生—外科学]